UNASSIGNED:本研究旨在探讨自我管理行为对脑卒中患者康复的影响,为使用患者报告结局(PRO)对脑卒中患者进行康复评估奠定理论基础。
UNASSIGNED:根据纳入和排除标准纳入2018年8月1日至2020年3月31日在大同市4家三级综合医院神经内科住院的396例患者。将纳入的患者随机分为自我管理干预组和对照组。对照组仅接受脑卒中康复临床路径干预。干预组脑卒中患者除接受脑卒中康复临床路径干预外,还接受自我管理干预。在入组后24h和3个月对患者的自我管理状况和康复效果进行评价,分别。采用SPSS20.0统计软件进行统计学描述和分析。患者的一般资料以百分比表示。有关患者自我管理和康复结果的数据按百分比进行统计描述,平均值和标准偏差。组间比较采用t检验和方差分析。Bonferroni方法用于多重比较校正。通过Pearson相关分析,探讨康复效果与患者基本状况及自我管理能力的相关性。通过多元逐步回归分析研究了自我管理行为的主要因素。
UNASHSIGNED:被调查对象的自我管理行为总分在不同年龄段取得统计学意义,职业,教育水平,收入水平,运动干预,既往病史,BMI,婚姻状况(P<0.01)。在这项研究中,不同性别、医疗保险状况差异无统计学意义(P>0.05)。自我管理行为总分及各维度得分与健康教育呈正相关,运动干预,功能训练,心理干预,食物摄入量,生活习惯,和中风患者恢复期的功能训练。文化程度、婚姻状况与患者康复效果呈正相关。针对中风的PRO问卷在已婚患者和受过高等教育的患者中得分较高,差异有统计学意义(P<0.01)。家族史与患者康复效果呈负相关。运动干预和功能训练与患者康复效果呈正相关。
未经评估:教育程度,健康教育,食物摄入量,运动和康复训练,睡眠,心理干预是影响脑卒中恢复期患者自我管理行为的主要因素。自我管理干预能有效提高脑卒中患者的健康教育水平,增强他们对疾病自我管理的自信心,促进患者建立有效的自我管理行为,提高他们的生活质量和主观幸福感。卒中PRO量表可从多个维度评价自我管理对脑卒中患者的临床干预效果,特别是评估患者主观心理和心理状态的改善,从而全面揭示自我管理对脑卒中患者的干预效果。
UNASSIGNED: This study aimed to investigate the effect of self-management behavior on the rehabilitation of stroke patients to lay a theoretical basis for using patient-reported outcome (PRO) for rehabilitation evaluation of stroke patients.
UNASSIGNED: 396 patients hospitalized in the Department of Neurology of 4 tertiary general hospitals in Datong from August 1st 2018 to March 31st 2020 were included in accordance with the inclusion and exclusion criteria. The included patients were randomly assigned into a self-management intervention group and a control group. Only the control group received the clinical pathway intervention of stroke rehabilitation. The stroke patients in the intervention group received the self-management intervention in addition to the clinical pathway intervention of stroke rehabilitation. The self-management status and rehabilitation results of the patients were evaluated in 24 h and 3 months after the patients were enrolled, respectively. Statistical description and analysis were conducted using SPSS20.0 statistical software. The general data of the patients were expressed by percentage. The data regarding patients\' self-management and rehabilitation results were statistically described by percentage, mean and standard deviation. The comparison between groups was drawn through t-test and analysis of variance. Bonferroni method was used for multiple comparison correction. The correlation between rehabilitation results and patients\' basic conditions and self-management was investigated through Pearson correlation analysis. The main factors for self-management behaviors were studied through multiple stepwise regression analyses.
UNASSIGNED: The total scores of self-management behaviors of the investigated subjects achieved statistical significance in different ages, occupations, educational levels, income levels, exercise intervention, past medical history, BMI, as well as marital status (P < 0.01). In this study, there was no statistical difference in different genders and medical insurance status (P > 0.05). The total scores of self-management behaviors and the scores of the respective dimension were positively correlated with the health education, exercise intervention, functional training, psychological intervention, food intake, living habits, and functional training of stroke patients at the recovery stage. Educational level and marital status were positively correlated with the rehabilitation results of patients. The PRO questionnaire for the stroke scored higher in married patients and highly educated patients, and there were statistically significant differences (P < 0.01). Family history was negatively correlated with the rehabilitation results of patients. Exercise intervention and functional training were positively correlated with the rehabilitation results of patients.
UNASSIGNED: Education level, health education, food intake, exercise and rehabilitation training, sleep, and psychological intervention were the main factors for self-management behavior in stroke patients at the recovery stage. Self-management interventions can effectively increase the health education level of stroke patients, strengthen their self-confidence in disease self-management, facilitate the establishment of effective self-management behavior of patients, and improve their quality of life and subjective well-being. Stroke PRO scale can be used to evaluate the clinical intervention effect of self-management on stroke patients in multiple dimensions, especially evaluating the improvement of subjective mental and psychological state of patients, thus revealing the intervention effect of self-management on stroke patients comprehensively.